The Minnesota attorney general has sued a Lakeville chiropractic clinic, accusing it of fraudulently pushing high-cost credit cards onto patients and pre-billing them for thousands of dollars worth of treatments.

The way the Express Health clinic promoted the so-called health care credit cards was “especially egregious,” Attorney General Lori Swanson said Wednesday.

Such credit cards help doctors get paid for expensive medical procedures but can leave patients with huge debts and monthly interest rates that can balloon as high as 30 percent.

In some instances, Swanson said, the clinic obtained cards without the consent of patients and then placed thousands of dollars of charges on them. In others, she said, the clinic inflated the income figures of patients to get them qualified.

“This is the health care version of subprime predatory mortgage lending,” Swanson said.

Her office said 150 patients have received cards through Express Health and its sole practitioner, Cory Coulliard. Some have been able to cancel the cards and any charges billed by the clinic, which also operates in Apple Valley and is promoted in shopping mall kiosks.

According to the lawsuit, the clinic charged more than $560,000 to its patients’ credit card accounts between late 2006 and this April. Roughly half of that was refunded to patients who complained.

Lindsay Westerkamp, of Burnsville, canceled the card after the clinic obtained it for her and then pre-billed it for $3,100 in chiropractic treatments. She learned through the attorney general that the clinic obtained the card by claiming that her $12,000 annual income as a waitress was actually $120,000 — and that she owned a house.

“I’m amazed,” she said. “That’s just a terrible thing to do to people — to intentionally bring them into debt.”

A call to Express Health wasn’t immediately returned.

Sanja Vosejkpa said she repeatedly told Coulliard during an office visit that she didn’t want the card, and yet she received one anyway. The first statement showed $2,900 in charges, even though she intended to pursue treatments with a different chiropractor closer to home.

The Lonsdale, Minn., woman said she felt that Coulliard used scare tactics about the condition of her neck and spine to recommend multiple treatments that she couldn’t afford and a credit card she didn’t want. Vosejkpa complained to the Minnesota Board of Chiropractic Examiners, which joined the attorney general in the lawsuit.

Express Health may be the target of the suit, but Swanson hopes the action sends a message to all clinics that are recommending these cards to patients. She said her office has received complaints from patients statewide who were pushed by doctors, dentists and other caregivers to obtain such cards.

In one instance, a 91-year-old with a $12,000 annual income obtained a health care card to pay for hearing aids. When she was late on one payment, Swanson said, the woman’s next bill included $1,200 in interest.

The lawsuit is but the latest by Swanson and her predecessor, Mike Hatch, to protect patients from questionable medical billing practices. In April, Swanson reached a $1.1 million settlement with Allina Hospitals & Clinics, which she had accused of gouging patients with interests rates as high as 18 percent on their medical debt.

In the latest case, Swanson is attacking one of the biggest growth areas for the credit card industry. Big names such as CapitolOne, Citi and GE all have health care card programs. Coulliard’s clinic provided patients with the GE’s CareCredit card.

Consumer credit counselors have expressed a number of ethical problems over doctors who recommend these cards to patients. At least in theory, they may be inclined to recommend expensive procedures and less likely to offer discounts or charity care to patients who use the cards to pay their medical bills.

Trade groups for the nation’s dentists, plastic surgeons and eye surgeons have endorsed the card programs, arguing that they can help people afford care they need sooner rather than later. Those medical specialties also see more patients who pay out-of-pocket rather than through health insurance.

A GE spokeswoman agreed with the attorney general that people must be careful when selecting credit cards that fit their budgets. However, she said most people are pleased with CareCredit and 80 percent pay off their cards during the initial promotional period when there is no interest.

Swanson said the cards take advantage of obvious gaps in the nation’s health care financing system. Her office issued a consumer alert for patients to be wary of high-pressure sales pitches by doctors or other caregivers.

“A clinic’s primary interest in marketing health care credit cards … is to boost its bottom line,” she said. “This may collide with the best interests of the patient.”

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